Living Organ Donation: All Your Questions Answered

There is an overwhelming need for living organ donors.

According to the U.S. Department of Health & Human Services, over 90,000 people are waiting for a kidney transplant and over 11,000 people require a liver transplant.

Loyola’s surgical director of intra-abdominal transplantation, Raquel Garcia Roca, MD, says, “The wait on the transplant list can last years."

"For patients and their families, this can cause fear and uncertainty. And not everyone receives a transplant in time.” In 2021, 5,800 people died while waiting for a kidney or liver transplant.

The good news is that a growing number of people are becoming living donors. Before the pandemic, living donor transplants reached an annual record of 7,389 in 2019. These recipients received a lifesaving gift from a family member, friend or stranger.

What are the different types of living donation?

The most common organs people donate are part of their liver or a kidney.

Because of the complexity of the surgery, the main type of liver donation is direct donation from the donor to the recipient. Usually, the donor is a family member or close friend.

In contrast, there are several options for kidney donation. You no longer have to be a match with your recipient — or even know them — to donate a kidney. The types of kidney donation are:

• Direct donation: This involves the transfer of a kidney directly from the donor to their intended recipient.
   
• Altruistic donation: This happens when the donor doesn’t have an identified recipient. The donor’s kidney goes to someone in need who is a good match. 
   
• Paired exchange: This occurs when a donor is not a match with their selected recipient. The simplest form of paired exchange is between two donor/recipient pairs. Donor A gives their kidney to recipient B and donor B gives their kidney to recipient A. Sometimes, long chains of donors and recipients can form.

Loyola Medicine partners with the National Kidney Registry (NKR) to coordinate altruistic donations and paired exchanges. “This partnership increases the pool of recipients and donors, providing the best possible matches and transplant success,” Dr. Garcia Roca says.

What are the qualifications to become a living donor?

In general, the qualifications for living donation include:

• Age: The minimum age for kidney and liver donation is 18, though you must be 21 to become an altruistic kidney donor. There is no set maximum age. 
   
• Health: You must be in good health. Some conditions may prevent you from donating, such as diabetes, cancer, active infections, substance abuse and untreated psychological disorders. 
   
• Intent: You must initiate the process for donation voluntarily and on your own. It’s a crime in the U.S. to receive payment or any form of compensation for donating an organ. 
   
• Organ function: It’s essential for you and the transplant recipient that your liver or kidneys are working properly. 
   
• Support: You will need a support system to help you take care of yourself after surgery and beyond. This team includes a primary care provider to monitor your long-term health. If you don’t have a primary care provider, the transplant team will help you establish care with one.

“It’s important not to rule yourself out based on what you think a typical organ donor should look like,” says Dr. Garcia Roca. “If you are interested at all in donation, go through the evaluation process to find out if you are eligible.”

How long does the living donor evaluation process take?

There is an extensive evaluation process to become a living donor. As you go through the process, it’s important to know that you can pause or stop at any time.

The steps of evaluation include:

• Questionnaire: This provides the transplant team with basic information about you and your current health, medical history and family history. 
   
• Tests: You will receive a wide range of tests to check your liver or kidney function and make sure you are healthy enough to donate. They include blood, urine and imaging tests, cancer screenings and a physical exam. 
   
• Psychological evaluation: You will meet with a psychologist to talk about why you want to donate and how donation may impact your health and family. 
   
• Medical evaluation: You will receive a full medical evaluation to assess your health and make sure donation is safe for you. 
   
• Financial counseling: The costs of organ donation are covered by the recipient's insurance but you may have other expenses. Loyola’s financial counselors will help you understand the costs and resources available for financial assistance.

The transplant committee will review your information and test results and decide if you can move forward with surgery.

Dr. Garcia Roca says that the evaluation process takes at least six weeks but can take longer depending on whether you need additional testing.

How long does recovery after living donation surgery take?

If you donate a kidney, you usually go home from the hospital the day after surgery. For most people, recovery takes about two weeks.

For liver donors, the hospital stay is five to seven days and up to four weeks to recover fully.

When can I go back to work after living donation?

Returning to work depends on your job. Office workers can go back to work after recovery. If your job is more active you may need to wait a few weeks longer.

For both types of donation, you cannot do any heavy lifting for 12 weeks. If you have a strenuous job, you won’t be able to work during that time.

What are the financial considerations for living donation?

The recipient’s insurance covers all costs associated with donation for up to 90 days after surgery. But insurance does not cover lost wages, lodging or transportation.

“There are several assistance programs and grants available for donors,” says Dr. Garcia Roca. “Our financial counselors know the ins and outs of these programs and can help you apply.”

What if I donate a kidney and my remaining kidney fails?

The risk of kidney failure after donation is very low. But if it happens, you receive credit for your donation through the United Network for Organ Sharing.

This credit moves you near the top of the U.S. transplant waiting list for a deceased donor kidney. If you donated through the National Kidney Registry, you may also receive prioritization for a living donor kidney.

What are the benefits and risks of donating a kidney or liver?

The main benefit of living donation is knowing you saved someone’s life. Many donors feel empowered by their good deed.

The risks of living donation include:

• Surgical risks: There is a risk of infection, bleeding and pain after surgery. Severe complications such as a pulmonary embolism or death are uncommon and occur in less than 1% of donors. 
   
• Psychological risks: Some donors report feeling guilt, stress, anxiety or depression, especially if the transplant is not successful.

Living donation at Loyola Medicine

Loyola’s transplant team is committed to providing individualized care throughout your evaluation, surgery, recovery and beyond.

You’ll receive one-on-one attention and can reach your coordinator at any time through a dedicated phone line and email address. Loyola also performs most kidney donor surgeries using state-of-the-art robotic technology.

To learn more about Loyola Medicine’s Living Donation Program, visit our program web page or call 708-327-3700.

Register Today to Become a Living Donor

Raquel Garcia Roca, MD, is a transplant surgeon and program director of the abdominal transplant program at Loyola Medicine. She loves watching her patients’ lives transform after a transplant as they feel healthier and more energetic. Her research interests focus on understanding and reducing disparities in living organ donation and optimizing robotic-assisted systems for transplant surgeries.

Dr. Garcia Roca earned her medical degree at the Universidad de Valencia Facultad de Medicina, Spain. She completed a residency in general surgery at Jackson Memorial Hospital and fellowships in transplant surgery at the University of Miami Hospital and University of Minnesota Medical School.

Book an appointment today to see one of Loyola Medicine’s expert primary care or specialty care physicians by self-scheduling an in-person or virtual appointment using myLoyola.